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Coronary artery calcification identified by CT in patients over forty years of age
Insights
Routine CT scans found coronary artery calcification in 41% of patients over 40. This incidental finding, especially in those under 60, strongly correlates with coronary artery disease, warranting further investigation.
Area of Science:
- Radiology
- Cardiology
- Preventive Medicine
Background:
- Coronary artery calcification (CAC) is a marker of coronary arteriosclerosis.
- Routine computed tomography (CT) of the thorax is increasingly performed for various indications.
Purpose of the Study:
- To determine the prevalence of incidental coronary artery calcification (CAC) on routine thoracic CT scans.
- To assess the association between incidental CAC and clinical evidence of coronary artery disease (CAD) across different age groups.
Main Methods:
- Retrospective analysis of 100 unselected patients aged 40 and older who underwent routine CT of the thorax.
- Correlation of identified CAC with existing clinical data on coronary artery disease (CAD) and hyperlipidemia.
Main Results:
- Coronary artery calcification (CAC) was detected in 41% of patients.
- Calcification of the left anterior descending artery was the most frequent finding (34%).
- For patients under 60, CAC was associated with a 5.5-fold increased likelihood of coronary artery disease (CAD) compared to those without CAC.
Conclusions:
- Incidental detection of CAC on routine thoracic CT is significant and indicates underlying coronary arteriosclerosis.
- Patients under 60 with incidental CAC should be evaluated for hyperlipidemia and undergo stress testing to rule out significant coronary artery disease (CAD).
Abstract:
In a study of 100 unselected patients forty years of age or older, routine CT of the thorax demonstrated coronary artery calcification in 41%. Calcification of the left anterior descending was most common, occurring in 34%. For patients 60 years of age and over, clinical evidence of coronary artery disease was 1.7 times more common in those with calcification compared to those without; however, for patients under 60, coronary artery disease was 5.5 times more common in those with calcification than those without. Because of the strong relationship that is known to exist between coronary artery calcification and coronary arteriosclerosis, we believe that the incidental discovery of coronary artery calcification on routine CT of the thorax has significance. All patients under 60 with coronary artery calcification discovered on CT should be investigated for hyperlipidemia if this has not been done, and, if they are not known to have a history of coronary artery disease, they should have a stress test and, if positive, arteriography may be warranted.